Implementing health technology assessment in Egypt
Case study
NICE International supports countries to improve their own nation’s health and wellbeing. It does this by sharing best practice and helping to drive improvements in evidence-based decision-making. In this case study, we explore our collaboration with the Egyptian Authority for Unified Procurement, Medical Supply and the Management of Medical Technology (UPA). This project focuses on supporting the UPA to establish health technology assessment processes, ensuring fair access for Egypt’s citizens.
“This is an exciting collaboration. It’s great to see the progress UPA is making to implement health technology assessment in Egypt. This important work will help balance best care with value for money, delivering both for individual patients and Egyptian society as a whole.”
Pilar Pinilla Dominguez, associate director of NICE International
“This collaboration is a great opportunity to speed up the steps needed to institutionalise health technology assessment processes in Egypt. There is no ‘one size fits all’ strategy for implementation. But having NICE as a supporting partner helps us to make wise choices.”
Ahmed Elagamy, head of planning and health economics at UPA
Our Egyptian partner
The UPA is an integral part of the Egyptian government's aim to achieve universal health coverage by 2030.
Established in 2019, it supports the efficient allocation of resources through strategic procurement.
Working with UPA
Through our international consultancy service, in October 2021 we carried out a scoping exercise with UPA. We needed to better understand:
- Egypt’s healthcare system
- their 2030 healthcare vision
- the context of health technology assessment in the country
- UPA’s aspirations.
We followed this up with a situational analysis of health technology assessment in Egypt. This helped us to better understand the opportunities, challenges and solutions for implementing health technology assessment in the country.
The analysis showed that key stakeholders already had a basic understanding of health technology evaluation processes and a willingness to support their implementation. But the small number of trained staff, able to conduct health technology assessment analysis, was a key barrier.
Pilar Pinilla Dominguez, associate director of NICE International, speaking at Africa Health ExCon 2022
Pilar Pinilla Dominguez, associate director of NICE International speaking at Africa Health ExCon 2022
As a result of this work, UPA invited Pilar Pinilla Dominguez, associate director of NICE International, and Dalia Dawoud, senior scientific adviser at NICE, to speak at Africa Health ExCon in June 2022. UPA was the key government organising partner in the conference and the session was a great opportunity to engage other relevant Egyptian stakeholders in the interaction between health technology assessment, pricing and managed access agreements.
Africa Health ExCon 2022 participants
Africa Health ExCon 2022 participants
To take this partnership forward, NICE and the UPA signed a statement of collaboration in July 2022. The UK embassy featured this at their Association Council between Egypt and the UK, resulting in stronger diplomatic relations between the 2 countries.
NICE and the UPA announced a new package of work in December 2022. As part of this, NICE reviewed UPA’s critical appraisals of evidence submissions and version 1.0 of their health technology assessment process guide.
NICE staff, along with colleagues from NHS England and the York Health and Economics Consortium, also provided capability building support covering topics such as:
- indirect treatment comparisons
- real-world evidence
- resource impact assessments
- managed access agreements
- the relationship between health technology assessment and procurement.
Key stakeholders, such as the Egyptian Ministry of Health, the Egyptian Drug Authority, and the Egyptian General Organisation for Teaching Hospitals and Institutes also benefited from these sessions.
Benefits and next steps
Relevant organisations in Egypt have formed a health technology assessment forum. The purpose of the group is to progress health technology assessment in the country.
UPA has published version 1.0 of its health technology assessment process guide. Following NICE’s comprehensive review, UPA has developed a 2-year plan to update the guide, accommodating NICE’s comments.
NICE and the UPA published a journal article summarising this important work - institutionalising health technology assessment in Egypt.
NICE and UPA are agreeing next steps. Future work, expected to start in autumn 2023, could focus on:
- further development of the health technology assessment process guide
- decision making within technology appraisal committees
- stakeholder involvement in health technology evaluation.
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